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Cognitive therapy improves three-month outcomes in hospitalized patients with heart failure
Rebecca L Dekker1, Debra K Moser, Ann R Peden
1University of Kentucky College of Nursing, Lexington, KY 40536-0232, USA. rdekker@uky.edu
Insights
A brief, nurse-delivered cognitive therapy intervention improved cardiac event-free survival in hospitalized heart failure patients. This intervention may enhance outcomes for patients experiencing depressive symptoms.
Area of Science:
- Cardiology
- Psychiatry
- Nursing
Background:
- Depressive symptoms are common in heart failure (HF) patients and worsen outcomes.
- Cognitive therapy may alleviate these symptoms and improve patient well-being.
Purpose of the Study:
- To evaluate a brief, nurse-delivered cognitive therapy intervention for hospitalized HF patients.
- To assess the intervention's impact on depressive symptoms, negative thinking, quality of life, and cardiac event-free survival.
Main Methods:
- 41 hospitalized HF patients with depressive symptoms were randomized to a control or brief cognitive therapy group.
- Intervention included in-hospital sessions and a 1-week booster call.
- Outcomes measured at 1 week and 3 months; cardiac event-free survival assessed at 3 months.
Main Results:
- Both groups showed improved depressive symptoms and quality of life.
- The intervention group had significantly better 3-month cardiac event-free survival (80% vs. 40%).
- The intervention group had a 3.5-fold lower hazard of cardiac events.
Conclusions:
- Brief, nurse-delivered cognitive therapy can improve short-term, event-free survival in hospitalized heart failure patients.
- Further research with larger samples is warranted to confirm these findings.
Background:
Patients with heart failure (HF) experience depressive symptoms that contribute to poorer outcomes. We tested the effects of a brief cognitive therapy intervention on depressive symptoms, negative thinking, health-related quality of life, and cardiac event-free survival.
Methods And Results:
Hospitalized patients with depressive symptoms (n = 41, 66 ± 11 years, 45% female, 81% New York Heart Association Class III/IV) were randomly assigned to control group or a brief, nurse-delivered cognitive therapy intervention, delivered during hospitalization and followed by a 1-week booster phone call. Depressive symptoms, negative thinking, and health-related quality of life were measured at 1 week and 3 months. Cardiac event-free survival was assessed at 3 months. Mixed models repeated measures analysis of variance, Kaplan-Meier, and Cox regression were used for data analysis. There were significant improvements in depressive symptoms and health-related quality of life in both groups but no interactions between group and time. The control group had shorter 3-month cardiac event-free survival (40% versus 80%, P < .05) and a 3.5 greater hazard of experiencing a cardiac event (P = .04) than the intervention group.
Conclusion:
Nurses can deliver a brief intervention to hospitalized patients with heart failure that may improve short-term, event-free survival. Future research is needed to verify these results with a larger sample size.
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